Reliability and validity of the Eating and Drinking Ability Classification System (EDACS) for children with cerebral palsy in Taiwan

Purpose The study was to assess the inter- and intra-rater reliability, construct validity and utility of the Eating and Drinking Ability Classification System (EDACS). Methods EDACS was translated into in Taiwan using an interactive process. Agreement between health professionals and teachers when using EDACS was assessed using Kappa and the Intraclass Correlation Co-efficient. Results Paired ratings of 4 (13%) health professionals (either speech or occupational therapists) and 26 (87%) teachers were obtained for 53 children with CP aged 6.7 years (SD 4.1 years), who worked in six education institutions. The raters used EDACS independently to classify children's eating and drinking ability and re-classified children's eating and drinking abilities after one month. Pairs of raters showed substantial agreement for the EDACS level at the first assessment (k = 0.75; absolute agreement = 81%; ICC = 0.94) and the second assessment (k = 0.70; absolute agreement = 77%; ICC = 0.95). The intra-rater reliability of EDACS level showed almost perfect agreement at rater 1 (k = 0.87; absolute agreement = 91%) and rater 2 (k = 0.87; absolute agreement = 91%). Conclusions We conclude that the Chinese version of EDACS is valid and reliable to be easily used by health professionals and teachers to classify functional eating and drinking abilities in children with cerebral palsy.

Automated summary

This study found that there is high agreement between health professionals and teachers in assessing the functional eating and drinking abilities of children with cerebral palsy using EDACS. This suggests that the Chinese version of EDACS is a valid and reliable tool for classification in this population.